Value-Based Cancer Care Issues

May 2014, Vol 5, No 4

Challenges Facing US Cancer Care in 2014: ASCO’s First Annual Report to the Nation

Eileen Koutnik-Fotopoulos

Economics of Cancer Care

Advances in cancer treatment, from detection and diagnosis to drugs, surgical techniques, and new imaging capabilities, have collectively enabled many patients to live longer, healthier lives with or after cancer. However, a new landmark report, “The State of Cancer Care in America, 2014: A Report by the American Society of Clinical Oncology” (ASCO), identifies the many challenges that will impact the future delivery of cancer care (ASCO. J Oncol Pract. 2014;10:119-143). These challenges include an increasing demand for care, predicted workforce shortages, rapidly rising costs, imbalances in access to care, and an unstable practice environment. [ Read More ]

AG-221 Achieved Excellent Responses in Relapsed, Refractory Leukemia, Myelodysplastic Syndrome

Phoebe Starr

AACR Annual Meeting

San Diego, CA—Preliminary data suggest that a novel agent called AG-221 can induce complete remissions (CRs) in patients with relapsed, refractory acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) who harbor mutated IDH2. These exciting results were achieved in patients with an ominous prognosis who have few or no other treatment options. The data were presented at the 2014 American Association for Cancer Research (AACR) annual meeting. [ Read More ]

Zykadia Approved for Metastatic, ALK-Positive Lung Cancer

FDA Approvals, News & Updates

The US Food and Drug Admin­istration (FDA) approved ceritinib (Zykadia; Novartis) for the treatment of patients with metastatic, anaplastic lymphoma kinase (ALK)-positive non–small-cell lung cancer (NSCLC). Ceritinib is an ALK tyrosine kinase inhibitor that blocks proteins that promote cancer cell growth. The drug is approved for the treatment of patients with late-stage NSCLC who were previously treated with crizotinib, the first and only other ALK tyrosine kinase inhibitor approved by the FDA. [ Read More ]

Frequent Mammography Screening for Breast Cancer Adds Billions to Cost

Rosemary Frei, MSc

Economics of Cancer Care

The total annual cost of mammography screening for women aged 40 to 85 years in the United States is estimated to be $7.8 billion, according to a new analysis (O’Donoghue C, et al. Ann Intern Med. 2014;160:145-153). That is $4.3 billion more than the cost would be if mammography intervals were lowered to fall in line with the recommendations of the US Preventive Services Task Force (USPSTF), the study researchers calculated. [ Read More ]

Payers Facing Multiple Challenges in Ensuring Access to Cancer Care

Wayne Kuznar

AVBCC 2014 4th Annual Conference

Los Angeles, CA—The cost of cancer care is a major cost driver for payers, who are actively engaging in the management of this complex disease state. Payer approaches to cancer care continue to evolve, with new reimbursement methodologies key to maintaining affordability, said Gary M. Owens, MD, President, Gary Owens Associates, Ocean View, DE, and John Fox, MD, MHA, Senior Medical Director and Associate Vice President of Medical Affairs, Priority Health, Grand Rapids, MI, at the Fourth Annual Conference of the Association for Value-Based Cancer Care. [ Read More ]

Potential New Approach to Melanoma

Phoebe Starr

AACR Annual Meeting

San Diego, CA—Preliminary results suggest that an investigational antibody-drug conjugate called DEDN-6526A (Seattle Genetics, Genentech) has activity against melanoma, including cutaneous, mucosal, and ocular melanoma, which is considered difficult to treat. The new drug comes on the heels of trastuzumab emtansine, the first antibody-drug conjugate approved by the US Food and Drug Administration for the treatment of breast cancer. [ Read More ]

ALK-Positive NSCLC Responds to Ceritinib Treatment

In the Literature

Non–small-cell lung cancer (NSC LC) harboring anaplastic lymphoma kinase (ALK) rearrangement is sensitive to the ALK inhibitor crizotinib (Xalkori). Despite initial responses to crizotinib, resistance ultimately occurs. In preclinical studies, ceritinib (Zykadia), a novel, oral adenosine triphosphate–competitive inhibitor of the ALK tyrosine kinase, has shown greater antitumor potency than crizotinib. [ Read More ]

PD-L1 Expression Potential Biomarker for Response to Immunotherapy with MK-3475

Phoebe Starr

Personalized Medicine

San Diego, CA—Two studies, one in melanoma and one in non–small-cell lung cancer (NSCLC), presented at the 2014 American Association for Can­-cer Research meeting attempted to correlate response to the anti–programmed cell death (PD)-1 inhibitor MK-3475 with the biomarker PD-L1. The hope is that the level of PD-L1 expression will be a biomarker for the selection of patients for treatment with this new agent. [ Read More ]

Up Next for the Center for Medicare and Medicaid Innovation: Cancer

Ross D. Margulies, JD, MPH; Jayson Slotnik, JD, MPH

Health Policy

In passing the Affordable Care Act (ACA) in 2010, Congress had as one of its central goals the creation of new, innovative ways of paying for and delivering healthcare services. With this goal in mind, the ACA established the Center for Medicare and Medicaid Innovation (CMMI), which is tasked with developing new payment and service delivery models to “demo” and, if successful, to eventually roll out nationwide. [ Read More ]

New Guidelines Expand Pool of Patients Eligible for Sentinel Node Biopsy

Alice Goodman

Breast Cancer

The American Society of Clinical Oncology (ASCO) has issued new guidelines for the use of sentinel node biopsy (SNB) in patients with early-stage breast cancer (Lyman GH, et al. J Clin Oncol. 2014;32:1365-1383. The newer version expands the use of SNB to a larger group of patients, based on evidence from 9 randomized trials and 13 cohort studies conducted since 2005, when the first SNB guidelines were published. [ Read More ]

Emerging Targeted Therapies for Advanced Pancreatic Cancer Show Promise

Wayne Kuznar

Pancreatic Cancer

San Francisco, CA—New cytotoxic combinations introduced over the past several years for the treatment of advanced pancreatic adenocarcinoma now constitute the standard of care for the treatment of all stages of the disease. Eileen M. O’Reilly, MD, Gastrointestinal Medical Oncologist, Memorial Sloan Kettering Cancer Center, New York, reviewed emerging treatments at the 2014 Gastrointestinal Cancers Symposium. [ Read More ]

Survivorship Care Plan Use Lagging

Rosemary Frei, MSc


Cancer centers are ramping up their efforts to create survivorship care plans (SCPs) for all of their patients. However, according to a new survey conducted in 2013, they still have far to go before January 1, 2015, when the American College of Surgeons Commission on Cancer (CoC) accreditation requirement of creating SCPs for all patients comes into effect (Birken SA, et al. J Cancer Educ. 2014 April 6. Epub ahead of print) [ Read More ]

Advances in the Treatment of Patients with Castration-Resistant Prostate Cancer

Wayne Kuznar

Prostate Cancer

Hollywood, FL—The treatment options for patients with castration-resistant prostate cancer (CRPC) have increased over the past few years. Understanding the clinical disease states is essential when choosing therapy for this patient population, according to Celestia S. Higano, MD, Professor of Medicine and Urology, University of Washington, Seattle, who described the recent additions to the therapeutic armamentarium at the 2014 National Comprehensive Cancer Network Conference. [ Read More ]

Treatment Paradigm for Lung Cancer Shifting Toward Targeted Therapies, Immunotherapy

Wayne Kuznar

Lung Cancer

Hollywood, FL—Driver mutations, most frequently KRAS and EGFR, account for approximately 50% of non–small-cell lung cancer (NSCLC), and this recognition is shifting the NSCLC treatment paradigm toward targeted therapy when possible, said Leora Horn, MD, MSc, Assistant Professor of Medicine, Division of Hematology/ Oncology, Vanderbilt University, Nashville, TN, at the 2014 National Comprehensive Cancer Network Conference. [ Read More ]

Imbruvica (Ibrutinib) the First Bruton’s Tyrosine Kinase Inhibitor Approved for Treatment of Patients with Relapsed Chronic Lymphocytic Leukemia

Lisa A. Raedler, PhD, RPh

Drug Updates

Chronic lymphocytic leukemia (CLL), the most common type of leukemia in adults, is a cancer of B-cell lymphocytes, which originate in the bone marrow, develop in the lymph nodes, and normally fight infection by producing an immune response. In CLL, excess B-cells accumulate in the bone marrow and blood, where they crowd out healthy blood cells. [ Read More ]